ABSTRACT
Oral mucosa was examined in 23 patients with acute myeloblastic leukemia before and after cytostatic polychemotherapy. Lesions of the oral mucosa were observed in all patients after polychemotherapy: its color was changed, atrophic processes developed in it, and salivary secretion was impaired. Destructive ulcerative changes were revealed in 35% cases; terms of their appearance, regression, and epithelialization were established and a clear-cut correlation between their development and severity of leukocytopenia was detected. Ranging of stomatitis severity is proposed, according to which medium-severe stomatitis predominates in this patient population. The study will help develop more effective approaches to prevention and treatment of oral complications and improve the results of therapy of this most grave category of hematological patients.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Leukemia, Myeloid, Acute/complications , Mouth Mucosa/drug effects , Adolescent , Adult , Female , Humans , Leukemia, Myeloid, Acute/blood , Leukemia, Myeloid, Acute/drug therapy , Leukocytes/drug effects , Leukopenia/blood , Leukopenia/chemically induced , Leukopenia/diagnosis , Male , Middle Aged , Mouth Mucosa/pathology , Stomatitis/blood , Stomatitis/chemically induced , Stomatitis/diagnosis , Time FactorsABSTRACT
Clinical and cytological studies in 41 hematological patients aged 19-70 years showed appreciable shifts in the immune status and nonspecific reactivity virtually in all examinees. Layers of cellular epithelium of late (V-VI) and early (III-IV) stages were more often detected in smears impressions than individual cells. Cells of stages I-II were scarce and never formed layers. In patients with leukemia, signs of dissociation of epitheliocyte nucleus and cytoplasm maturation were observed ("mature" cytoplasm and "young" nuclei). These specific shifts should be borne in mind when rendering dental care to hematological patients.
Subject(s)
Dental Care for Chronically Ill/methods , Hematologic Diseases/therapy , Mouth Diseases/therapy , Tooth Diseases/therapy , Acute Disease , Adult , Aged , Chronic Disease , Dental Care for Chronically Ill/statistics & numerical data , Female , Hematologic Diseases/complications , Hematologic Diseases/diagnosis , Humans , Male , Middle Aged , Mouth Diseases/diagnosis , Mouth Diseases/etiology , Oral Health , Tooth Diseases/diagnosis , Tooth Diseases/etiologyABSTRACT
Impressions from various sites of the buccal mucosa of 20 normal subjects aged 16 to 33 years were examined. Mature epitheliocytes of the V differentiation stage predominate in the cytological impressions of the lingual and buccal mucosa. Cells of the V stage of differentiation predominate in the lower lip mucosa, and there are just few cells of the IV (transitional) stage. In impressions of the palatal mucosa mainly cells without nuclei (stage IV) were found. These data will help more objectively assess the cytological findings in different diseases involving the buccal mucosa.
Subject(s)
Mouth Mucosa/cytology , Adolescent , Adult , Cell Differentiation , Epithelial Cells , Female , Humans , Male , Reference ValuesABSTRACT
Four patients with acute leukemia suffering from a chronic secondary illness (CSI) which developed 1.5 to 34 months after allogenous transplantation of bone marrow are described. One patient (female) was followed up over time: 14, 15, and 20 months after CSI was diagnosed, the rest patients were examined once, 15.5, 23, and 29 months, respectively, after the disease was diagnosed. Besides visual characterization of the buccal mucosa, results of cytologic examination of smear impressions are presented. Specific features of mucosa involvement at the peak of clinical manifestation of CSI and later, when the rest symptoms of secondary disease to a certain measure regressed, are described. The authors emphasize a similarity between the detected changes in the buccal mucosa and those observed in diseases which might be caused by immunity disorders.
